FEBRUARY 7, 2012

Welcome to the Comparative Effectiveness Update eNewsletter
This issue is sponsored by the Pay for Performance Summit

Comparative Effectiveness Research Plan Seeks Input From All Sides
An independent medical effectiveness research organization has outlined a broad agenda that does not name specific diseases but instead seeks input from patients and other stakeholders on what specific research questions and areas it should pursue. The Patient-Centered Outcomes Research Institute was created by the health system reform law to advance public knowledge of the comparative effectiveness of different types of medical care. Such research often compares the relative impact of drugs, medical procedures and medical devices on patients with the same conditions. (American Medical Association, February 6, 2012)

Survey Finds Public Support for Randomised Medicine Studies in Scotland
Studies of the effectiveness and safety of prescription medicines in Scotland that randomise prescribing policy in different GP practices are broadly supported by the general public, a survey carried out for the University of Dundee has found. The survey showed that 97% of the general public participants agreed that the NHS has a duty to determine the safety and effectiveness of the medicines its doctors prescribe. (Health Canal, February 2, 2012)

Challenges and Opportunities for PCORI and CER
In a time of skyrocketing health care costs, both the private and public sectors struggle to balance economics with access to high quality health care. Evidence from comparative effectiveness research (CER) and "head-to-head" clinical trials is increasingly being used in health care treatment decision-making around the globe, but how will this affect access to quality care? More importantly, where will the public draw the line between cost and access? (Alliance for Aging Research, January 30, 2012)

Comparative Effectiveness Research
Physicians are not likely to admit and patients would not be happy to learn that much done in the practice of medicine is based on little more than custom. Historically, the absence of well designed, statistically sound randomized clinical trials, RCTs, has not discouraged the introduction and use of ineffective, costly treatments with significant risks and complications. (The Huffington Post, January 26, 2012)

Comparative Effectiveness Body Releases Research Draft Priorities for Public Comment
A comparative effectiveness entity set up by the health reform law will initially focus its research on broad topics and will not single out any specific diseases or conditions, according to the organization's draft agenda for research priorities, released for public comment Jan. 23. The National Priorities for Research and Research Agenda will be used to guide funding announcements for comparative clinical effectiveness research that will give patients and those who care for them the ability to make better-informed health decisions, the Patient-Centered Outcomes Research Institute (PCORI) said in a statement. (Bloomberg BNA, January 24, 2012)

First PCORI Report Short on Specifics
The Patient-Centered Outcomes Research Institute issued its heavily anticipated first report on national priorities Monday, but stopped short of specifying any diseases or conditions that many hoped or feared the $4.5 billion agency would target for comparative effectiveness research. (HealthLeaders Media, January 24, 2012)

Panel Sidesteps Controversy On Draft For Comparative Effectiveness Research
The Patient-Centered Outcomes Research Institute (PCORI) -- created by the health law to help determine the most effective medical treatments -- released its draft priorities and research agenda on Monday, but it did not single out any specific diseases, treatments or procedures to study. Instead, the nongovernmental institute that will oversee billions in research funding "specifies a set of questions and topics" in five broad categories. (Kaiser Health News, January 23, 2012)

PCORI Seeks Input on Draft Research Agenda
The Patient-Centered Outcomes Research Institute is asking providers and patients for their feedback on its newly released draft research agenda and priority list (PDF). PCORI is an independent not-for-profit organization, established by the healthcare reform law to perform and promote comparative-effectiveness research. (Modern Healthcare, January 23, 2012)

Draft NICE Guidance Says More Evidence Needed on New Test to Guide Breast Cancer Treatment Decisions
Draft guidance from NICE's Diagnostics Assessment Programme on four tests used to guide decisions about the use of chemotherapy in women with early breast cancer is issued today for consultation. The draft guidance recommends that the IHC4 test is used in a research setting to collect evidence about the reproducibility of the test and important outcomes associated with the prognostic ability of the test and to determine the ability of IHC4 to guide clinical decision-making in patients with early breast cancer. (NICE, January 2012)

Comparative Effectiveness Research and the Changing Health Care Landscape
In the span of just one year, the health care landscape has undergone dramatic changes. Many elements of the health reform law -- the Patient Protection and Affordable Care Act -- have gone into effect, and elements like comparative effectiveness research (CER) are now more widely understood by policy makers as potential tools to improve patient health outcomes. Included in this vast new landscape is the creation of the Patient-Centered Outcomes Research Institute (PCORI), the public-private entity charged with overseeing CER. (NPC, January 2, 2012)

Interview: Health Reform's Comparative Effectiveness Chief

Joe Selby, executive director of the Patient Centered Outcomes Research Institute. In late 2011, a doctor named Joe Selby was charged with a very big task: Figure out which health care treatments are most effective. Selby is the first executive director of the Patient-Centered Outcomes Research Institute, an independent body created by the health reform law that has a $3 billion budget for comparative effectiveness research. (The Washington Post, January 26, 2012)

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How States are Using Comparative and Cost-Effective Research to Make Policy Decisions

Mark Gibson
Deputy Director, Center for Evidence-Based Policy, Oregon Health and Science University; Program Officer, Milbank Memorial Fund; Former Chief of Staff, Oregon Senate President John Kitzhaber, Portland, OR